Tuesday, December 12, 2017

Diabetes Reversal by Plant-Based Diet

Journal of Metabolic Syndrome.

Research Article by Dr. Biswaroop Roy Chowdhury*
Medical Nutritionist, Indo-Vietnam Medical Board, India.

ABSTRACT :

Introduction: Diabetes causes a never-ending medicine and or insulin treatment for the diseased. Also, the patients are bound to follow a particular diet, with eliminating most of the sugary foods; that further deteriorates the quality of life. This gave way to the study, focused on diabetes cure without medicines and on rich fruits and vegetable diet. The clinical trial on 55 diabetes patients with a team of 6 medical associates was practiced for 3- days at Zorba, The Buddha, 10 – Tropical Drive, Ghitorni, New Delhi from 29th April to 1st May, 2016. The goal was to establish and observe the effects of plant-based diet on the sugar levels of the diabetes patients. These included both insulin-dependent and independent, diabetes type-1 and type-2 patients. The 3-days Residential Treatment Tour involved 55 subjects with different age groups and demographic profiles. The study considered participants from different countries to find out the global impact of the treatment.

Objective: The burden of the disease diabetes is rising globally. The aim of the research is to find out that on discontinuing the medicines and being on a particular plant-based diet, can high blood glucose levels in diabetes patients be normalized.

Methodology: Clinical trials were performed on diabetes patients for 3-days continuously. The sample size of the study was n=55 patients. Medicines were eliminated from the first day of the trial. Thereafter, following 3-days, the participants were kept on a prescribed plant-based diet. Both fasting and post-prandial readings were measured each day along with the weights of the participants. The subjects with varying diabetes history, age groups, type of diabetes, insulin dependency and demographic profiles were part of the trial.


Findings of the study: The study reported controlled* blood glucose levels for 84% of patients and partially-controlled* levels for 16% of patients. Those with controlled* levels could attain a healthy blood glucose range without medicines and or insulin, along with the prescribed diet in 3-days. Those with partially controlled* levels could attain a healthy blood glucose range with less than 50% of insulin than prescribed earlier. Among diabetes type-2 patients the study reported 100% results with all the patients maintaining a healthy blood glucose level. While among diabetes type-1 patients, 57% reported controlled* blood glucose levels through the diet and zero-medications. Whereas, 43% reported healthy blood sugar levels through the diet and insulin reduction. In addition of the insulin-dependent group, 59% could completely drop their insulin requirements and 41% could reduce the requirement to at least 50%. The weight reduction for 55 patients in 3-days was reported as 1.14 kgs of average weight loss per individual. Also, the patients had symptomatic relief from general fatigue and weaknesses. The plant-based diet proved to be beneficial with regards to energy and nutritional fulfillments.

Future scope: Diabetes treatment has both health and economic burden on society. With reference to the present research, a new approach for the treatment of this considered life-style metabolic disability can be shaped. The plant-based diet has 
been found effective to cure and control diabetes, 
eliminating the medicine or insulin requirements. 
Further research on the subject matter can present 
a medicine-free-food-science based treatment for 
the disease. At the same time, this unique 
treatment approach will eliminate the risks of 
medicine side-effects. On the basis of this research, 
diabetes education can be developed for better 
understanding of the disease and better living for 
the diseased population. 

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Keywords: Plant-based diet; Diabetes; Diabetes 
type I and type II; Insulin dependent; Blood 
glucose levels

Introduction

In the latest Clinical Practice Recommendations 
provided by the American Diabetes Association
-ADA, Medical Nutrition Therapy is highly recommended for Diabetes care. However, they could not define a dietary pattern or establish a specific nutrition therapy for delay or prevention of the risk of diabetes. They further suggested increased intake of whole grains, fruits, vegetables and legumes, reducing refined and sugary foods [1]. In addition, intensive life-style changes were reported to be 58% effective after 3 years by the ADA [1].

The Medical Nutrition Therapy for diabetes paved 
its way through many randomized trials, meta-analysis and observational studies [2]. Improved glycemic and metabolic control were evident with reduction in A1c and blood glucose levels in diabetes patients. The results reported favored both type 1 and 2 population and worked irrespective of disease duration [2]. Moreover, it was also established that life-style interventions work better than metformin in reducing the incidence of type 2 diabetes [3]. The research in hand presents a defined model of managing diabetes with plant-based diet protocol eliminating the need for medications. The study will provide a strong foundation with extensive future scope for research due to its practical implications.

Review of Literature
The correlation between life-style orientations and diseases has been profound. The present research is rooted within the vast literature present in support of association between diabetes and diet. Some of the related studies have been listed below.


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Glycemic control and diabetes
In the study presented by Riccardi et al. on 
glycemic control in diabetes, they could 
establish a deep relationship between pre-diabetes and type 1 and 2 diabetes with high glycemic load. Figure 1 shows the effects of high/low glycemic index (GI) on blood glucose levels in type1 Diabetes patients, similar results were seen in type 2 diabetes patients (Figure 1).

The glycemic load is explained as glycemic index (GI) of a particular food multiplied by the amount of carbohydrate contained in an average portion of the food consumed [4]. The study supported low GI and high fiber-rich diet to manage post-prandial blood glucose levels in pre-diabetes and diabetes [4].

Studies also reported that glycemic index can be 
used as an effective marker along with fiber-
content and nutritional value to classify 
carbohydrate rich foods and their preferences in 
routine diet [5]. This presented relevance in case of diabetes control and prevention. In addition, a comparative study for glycemic index or the quantity of carbohydrates on glycated hemoglobulin, C-reactive proteins, lipids and plasma glucose on type 2 diabetes patients gave positive results [6]. The outcomes of the 1-year controlled trial on 162 type 2 patients managed by sole diet gave the mean C-reactive protein being 30% low in low-GI diet in a comparison to high GI diet. The study reported sustainable reductions in post-prandial glucose level and C-reactive proteins and referred the diet management system to aid in type 2 diabetes management [6].

Animal protein and diabetes

The Singapore Chinese Health Study (SCHS) 
investigated association between dietary patterns 
and risk of type 2 diabetes in Chinese men and 
women in Singapore [7]. The study examined 43,176 
individuals aged 47-74 years and diabetes free. The study performed Cox regression for diet pattern scores and risk of type 2 diabetes in individuals [8]. Their dietary patterns showed positive relation between meat-rich foods and risk of type 2 diabetes. Whereas fruits, vegetables and soy-rich foods inversely affected risk of type 2 diabetes [8]. Meat consumption and incidence of type 2 diabetes has been elucidated in a cohort study of 4,366 Dutch participants [9]. This study delivered the effects of processed meat on insulin resistivity and incidence of type 2 diabetes. The heating up of meat leads to the formation of AGEs (Advanced glycation end products) [10,11]. It is expected that the 
proinflammatory properties in AGEs may attribute towards the induced risk of type 2 diabetes [12]. Moreover, presence of saturated fatty acids in meat can even contribute to the risk of type 2 diabetes [13].

Cow’s milk consumption and diabetes
Campbell’s China Study 2005, a guide to nutrition 
and health reported that milk protein casein is not 
fit for human consumption. The proteins in cow’s 
milk have been found to be responsible for autoimmune diseases especially type 1 diabetes; mostly in children with genetic susceptibility [14]. This was explained as, may be in most of us; the body’s immune cells are unable to distinguish between the protein fragment of cow’s milk and the β-cells of the body. Consequently, the immune cells attack the β-cells of the body resulting in diabetes or other autoimmune diseases [14].

 An overview of medical literature on early cow’s milk exposure and type 1 diabetes reported an increase of risk factors by approximately 1.5 times [15]. Higher anti-casein antibodies were also observed in children with type 1 diabetes [16]. In a popular study, a linear model was obtained on analyzing age-standardized prevalence of diabetes among children of 0-14 years of age in 12 countries. The countries were Finland, Sweden, Norway, Great Britain, Denmark, United States, New Zealand, Netherlands, Canada, France, Israel, and Japan [17] (Figure 2).

  Among them, Finland had the highest incidence 
of insulin-dependent type 1 diabetes, which was 
35 times higher than Japan. Finland has the 
world’s highest cow’s milk and milk products
consumption and subsequently highest prevalence of diabetes [18]. The research concluded that cow’s milk may be responsible for development of insulin-dependent type 1 diabetes. 

Plant-based diet and diabetes
In support of plant-based diet, a cohort study 
involved 3,704 participants with 653 diabetes 
patients from European Prospective Investigation 
[19]. The study examined the association between intake of fruits, vegetables and fruits and vegetables in combination along with their variety and quantity and risk of type 2 diabetes [19].

↓Page 3 of 7.

 The research analyzed 11-year incidence of type 2 diabetes, and reported 21% lower risk of diabetes with greater fruits and vegetables intake in diet (Cooper et al., 2012). A research based on epidemiological and clinical trials found that nuts can improve post-prandial glycemia and reduce the risk of diabetes [20]. Many studies have reported the relation between nut consumption and metabolic syndrome (MetS). Metabolic Syndrome is a group of cardio-metabolic risk factors, which comprise of type 2 diabetes, high fasting plasma glucose, hyperglycemia, 
hypertriglycerides, low HDL cholesterol and abdominal obesity [21].

  Metabolic syndrome raises the risk of diabetes by 
5 times and that of cardiovascular diseases for diabetes population by 2 to 5 times [22]. Nuts have been found to play an important role in adjusting the components of MetS by influencing inflammation, oxidative stress, and endothelial function. This in process influences the insulin sensitivity and reduces chances of diabetes, hypertension and obesity [20].

  Also, three cohort studies could establish a 
reduced risk of type 2 diabetes by 27%, 20% and 33% respectively by nut intake in regular diet in women in the Nurses’ Health Study (NHS, in the NHS and NHS II cohorts) [23, 24] and women in the Shanghai Women’s Health Study [25]. A significant research published in the Current Atherosclerosis Reports-2010 demonstrated that, the time of cooking is directly proportional to the increase in glycemic index (GI), resulting in lot of burden on the blood sugar making a person more prone to diabetes [26]. In the same research it was proved that the simple whole grain consumption in its natural state helps the diabetic patient to get a more stable and acceptable blood sugar. However, the refining followed by cooking of the grains rapidly shifts the grains from the low GI range to high GI range [26].

Research design

The 3-days Residential Treatment Tour was 
conducted at Zorba, The Buddha, 10-Tropical Drive, Ghitorni, New Delhi from 29th April to 1st May, 2016 with 55 diabetes patients and 6 Medical Analysts. The Residential Treatment Tour was publicized among masses both online and through seminars. The procedure required form-filling of DAM form-Diet and Medicine information by the patients. By the time of the beginning of the tour, 60 patients could furnish all details along with completion of the desired formalities of the tour. However, 5 of them had to leave because of personal reasons. Therefore, our sample size was reduced to 55 patients. The procedure was planned to keep the 55 subjects on 3-days plant-based raw fruits and vegetables diet. The medicines were discontinued at the start of the plan. Meals were provided as per the diet plan with appropriate quantities based on the patient’s weight. Regular blood-sugar readings - fasting and post-prandial were taken 
and individuals’ log-sheets were further 
maintained. The diet plan was all different for 3-days and was especially designed to fulfill the nutritional requirements of the patients.

Table 1, gives the scheduler depicting the events 
for Day 1, Day 2 and Day 3. All the patients were provided the scheduler before the start of the reversal tour. The planner was followed strictly, and observations on blood glucose readings, fluctuations and related parameters were precisely documented (Table 1).

The ingredients that formed the plant-based diet 
have been listed in Table 2, along with the quantities per individual for 3-days of reversal tour (Table 2). 

Establishment of blood glucose threshold
For the research trial, the diagnostic criteria for blood glucose levels in 55 diabetes patients was taken to be 250 mg/dl post-prandial sugar level. The study was structured taking two important variables as -

1.Controlled Blood Glucose Level*

2.Partially Controlled Blood Glucose Level*

Controlled Blood Glucose Levels: The controlled 
levels denoted the blood glucose range of ≤ 250 
mg/dl without medicines and or insulin 
requirement, along with the prescribed diet in 3-days. In this
group of people, the diet alone balanced the glucose levels, leading to zero requirement of medicine or insulin.

Partially Controlled Blood Glucose Levels: The partially
controlled levels denoted the blood glucose range of ≤ 250 mg/dl with less than 50% of insulin intervention than prescribed earlier. In this group, the diet could help maintain the blood glucose readings with minimum and much reduced insulin dosage.

↓Page 4 of 7.

 For example, a 30 yrs male with 20U of insulin for the day, required only 3U of insulin under the diet therapy. 

 This cut-off limit has been well established in the book Last-Days of Diabetes [27]. Chowdhury (2016). For Doctors & Care Givers. The section ‘Calculation’ of the book brings out the core understanding of the world-wide establishment of blood glucose reference range as 250 mg/dl, Available at: https://www.biswaroop.com/9312286540.pdf

Findings of the study

The study reported 46 patients with controlled 
sugar levels and 9 with partially-controlled 
sugar levels. The valid percentages obtained 
were 84% and 16% under controlled and 
partially controlled groups respectively shown 
in Frequency Table and Correlation Table 
below (Table 3).

In this trial 21 patients were type 1 diabetic and 
34 patients were type 2 diabetic. Among type 1 
patients 57% could attain controlled blood 
glucose readings and 43% attainted partially 
controlled readings. Among type 2 diabetes 
patients, 100% gave controlled sugar readings 
through the process shown in correlation table 
below (Table 4).

  The trial had 40% insulin-dependent cases, of 
these 59% could completely drop their insulin 
requirement to zero and 41% could reduce the 
levels by at least 50% of the earlier requirement 
shown in correlation table below (Table 5).

  An important observation is that 100% results 
were obtained with patients with above 10 years 
of disease history, as all the 5 subjects maintained 
controlled sugar levels. For those newly diagnosed 
or less than 1 year of disease history, 78% could 
attain controlled blood glucose readings.

  Below is Bar Chart-1 of two variables the 
attained sugar levels and disease duration in 
55 Diabetes Patients (Figure 3).

  Maximum number of patients were with a disease 
history of ˂1 year, 78% of these reported controlled 
readings, following them were patients within 1-5 
years of disease history, who gave 92% controlled 
results, and 80% controlled results for the group 
with 5-10 years of disease history shown in 
frequency table below (Table 6). 

 The findings of the study gave 1.14 kilos of 
average weight loss per individual of total 55 
cases. Among these, 9 subjects could reduce more 
than 3 kilos of weight in 3-days of plant- based 
diet treatment along with good control over blood 
glucose levels. Almost half of the cases could 
reduce.<1 during="" kilos="" of="" span="" the="" trial.="" weight="">

 Below is the pie-chart with valid-percentages of 
weight reduced among 55 subjects (Figure 4).

Of the total 55 subjects, 16% reduced ≥ 3 kilos of weight, following them were 20% of patients with 2-3 kgs of weight reduction and 14% could reduce 1-2 kilos of weight during 3-days. Whereas, 49% reported. Among patients with different age-groups, all of those ≥ 50 years of age could attain controlled sugar levels. Those below 20 years of age showed 40% controlled and 60% partially controlled sugar levels. This could be related to the little difficulty faced by young children to consume raw-food in those 3-days and report effective results. Below is the bar-chart plot between two variables-attained sugar levels and age groups in 55 diabetes patients (Figure 5).

  The Bar Chart-2 clearly shows the maximum subjects ≥ 60 years of age under controlled group following them are the subjects in 30-40 age  group, the 40-50 and 50-60 age groups had equally effective outcomes (Tables 8,9).

 Results: Of 55 cases, 41 were males and 14 were 
females. Among them, 83% of males and 86% females could attain controlled blood glucose readings by the end of 3-days diet treatment. The outcomes clearly support the diet protocol to be equally effective in both the genders.

Page 5 of 7 (click here to see charts and tables) 

↓Page 6 of 7.

Conclusion

There had been extensive research on changes in 
life-style and diet to cure diabetes, but rare could 
establish a practical approach. Also, most research 
work is based on one particular type of food or
parameter in terms of diabetes or cardiovascular 
diseases. Besides this, it is important to relate the 
nutritional fulfillment through diet in terms of 
healthy carbohydrates, proteins, fats, vitamins, 
minerals and anti-oxidants. Furthermore, 
consideration of body’s metabolism through the 
functional and metabolic pathways can only 
provide the actual effect of the food in the body. 
The plant-based diet protocol has the similar 
design and works to aid the effective mechanisms 
in body. Eliminating the toxic components in food, 
the diet covers all the nutritional requirements.

The plant-based diet in the form of raw fruits and 
vegetables has the ability to reduce blood glucose 
levels both fasting and post-prandial. The diet is 
suitable for diabetic individuals. The diet has shown 
effect in case of both type 1 and type 2 diabetes 
patients. The diet process could reduce the insulin 
dependency for most of the patients by at least 
50%. Disease duration was not a hindrance, as 
similar effects were seen in subjects with above 
10 years of disease history and with newly 
diagnosed diabetes patients. The diet proved to be 
beneficial irrespective of variable age groups and 
demographic profiles. Besides, weight reduction by 
plant-based diet with quality nutrition makes the
diet suitable for diseases associated with obesity or 
high fatty acids and related metabolic and cardio-
vascular diseases.

Post tour follow-ups
The necessary follow-ups were practiced post 
3-days of Residential Tour. Most of the patients 
who maintained the diet protocol in their routine 
gave affirmative response. For most of them their 
medications completely dropped. Few of them 
could even maintain a healthy lifestyle with no-
medicines even for common fevers. The remaining, 
who were still on medicines have been reducing 
them slowly with the diet protocol. Follow-ups 
and advices are still carried over when required.

References
1. American Diabetes Association (2015) Standards 
of Medical Care in Diabetes-2015 Abridged for 
Primary Care Providers. Clinical Diabetes [Internet]
33: 97-111.

2. Campbell TC, Ii TMC (2005) T. Colin Campbell, 
PhD and Thomas.

3. Chowdhury BR (2016) For Doctors & Care 
Givers.

4. Cooper AJ, Sharp SJ, Lentjes MA, Luben RN, 
Khaw KT, et al. (2012) A prospective study of 
the association between quantity and variety of fruit 
and vegetable intake and incident type 2 diabetes. 
Diabetes Care 6: 1293-1300.

5. Dahl-Jorgensen K, Joner GHK (1991) 
Relationship Between Cows’ Milk Consumption 
and Incidence of IDDM in Childhood. Diabetes 
Care 14: 1081-1083.

6. Feskens EJM, Kromhout D (1990) Habitual 
dietary intake and glucose tolerance in 
euglycaemic men: The zutphen study. Int J 
Epidemiol 19: 953-959.

7. Gerstein HC (1994) Cow’s milk exposure and 
type 1 diabetes mellitus: a critical overview of 
the clinical litterature. Diabetes Care 17: 13-19.

8. Hankin JH, Stram DO, Arakawa K, Park S, Low SH, et al. (2001) Singapore Chinese Health Study: development, validation, and calibration of the 



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